AMA debates study over paying would-be donors for organs

Monday, December 3rd 2001, 12:00 am

By: News On 6

SAN FRANCISCO (AP) _ As the nation's need for organ transplants continues to outstrip supply, the American Medical Association grappled with a possible solution once thought taboo: paying dying would-be donors and their families for vital organs.

Such financial incentives are illegal, banned by Congress in 1984, and as a result people needing organ transplants must rely strictly on volunteers, a system that is failing, said many doctors attending the AMA's 2001 Interim Meeting of the House of Delegates on Sunday, the association's 549-member policy-setting body. A majority vote by the members becomes official AMA policy.

An AMA committee, the Council on Ethical and Judicial Affairs, is recommending that the association support studies to determine if financial incentives will motivate more organ donations.

Some 15,000 people die each year awaiting organ transplants as only one-third of potentially valuable organs are donated, according to the United Network for Organ Sharing, the nonprofit agency the U.S. The other two-thirds are buried along with the dead.

``We see little moral value in burying perfectly good organs,'' said Dr. Stephen Schwartz who represented the 36 Pennsylvania delegates during debate on the issue Sunday.

Delegations from California, New York and Illinois _ the three largest _ also voiced their support for the proposal.

Most organ donation decisions are made by families of people who have died suddenly and unexpectedly _ such as in a car crash. Most families in that situation decline to offer up their dead relatives for donations.

``We have a nationwide crisis and altruism doesn't seem to be hacking it right now,'' said Dr. Frank Riddick Jr., chairman of the ethics commission.

Riddick's council is urging the AMA to study what effect financial incentives would have on organ donations. The full AMA will decide, perhaps as early as Tuesday, if it will adopt the recommendation.

The proposal has drawn passionate opposition from other AMA attendees, who view financial incentives as unethical.

``I have a problem with treating the body and the human as property,'' said Dr. Michelle Petersen, representing the eight Nebraska delegates. ``This is nothing more than a sale. This is a slippery slope.''

Dr. Michael Greene, representing the 15 Georgia delegates, said it would create an unfair commercial market for organs that would exploit the poor and mostly benefit the wealthy.

``The marketplace will determine what organs cost,'' Greene said.

If the AMA does agree with testing financial incentives, Congress will have to change current law to allow for any study. One such program, passed by the Pennsylvania legislature in 1999 that would have the state pay $300 toward the funeral of every donor, has never been implemented because of the federal ban.

At the time Congress enacted the ban, most in the organ donor field found financial incentives unethical and abhorrent _ including the AMA. Only two professionals vocally favored incentives at the time, including a defrocked doctor who went into business as a for-profit kidney broker.

Even today, many in the organ donation field find financial incentives distasteful.

``Most donor families we talked to are quite offended at the thought that financial incentives would have made a difference,'' said Phyllis Weber, executive director of the California Transplant Donor Network, which collects about 700 organs a year. ``In fact, financial incentives could backfire.''

``There's a thought that to offer financial incentives will open up a Pandora's Box,'' said Joel Newman of the United Network.

A Congressional bill introduced in May would allow a donor family a $10,000 tax credit in exchange for donated organs.

``There seems to be no compelling reason why viable solid organs should be treated differently from less complex tissues on moral grounds,'' the council report states. ``Moreover, donation itself implies a property right in organs.''